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Dangers of Herpesvirus Infection in SLE Patients Under Anifrolumab Treatment: Case Reports and Clinical Implications.
Larsen, Mads Lamm; Skouboe, Morten Kelder; Mogensen, Trine Hyrup; Laursen, Alex Lund; Deleuran, Bent; Troldborg, Anne; Rasch, Mads Nyhuus Bendix.
Afiliación
  • Larsen ML; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
  • Skouboe MK; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
  • Mogensen TH; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
  • Laursen AL; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
  • Deleuran B; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
  • Troldborg A; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
  • Rasch MNB; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Am J Case Rep ; 25: e944505, 2024 Sep 09.
Article en En | MEDLINE | ID: mdl-39245905
ABSTRACT
BACKGROUND Anifrolumab, a monoclonal antibody targeting the type 1 interferon (IFN-I) signaling pathway, holds promise as a therapeutic intervention for systemic lupus erythematosus (SLE). However, its use is associated with an increased risk of infections, particularly viral infections like herpes zoster (HZ). Results from the clinical trials on anifrolumab show yearly rates of upper respiratory tract infections of 34% and HZ of 6.1%. An increased frequency of other specific viral infections, including herpes simplex virus (HSV), was not reported. CASE REPORT Here, we present 2 cases of patients with SLE treated with anifrolumab, both experiencing severe adverse reactions in the form of disseminated herpesvirus infections, specifically disseminated HSV-2 and varicella zoster virus (VZV, HZ encephalitis). To the best of our knowledge, no previous reports of severe disseminated HSV-2 or HZ have been published in anifrolumab-treated patients. The patient in case 1 experienced a primary HSV-2 infection following anifrolumab treatment, potentially explaining the severity of the infection. The patient in case 2 had a history of previous HZ skin infections, which may have increased her risk of disseminated infection. Both patients recovered from the infections with minor sequelae, but they still require prophylactic antiviral treatment. These cases highlight the critical role of IFN-I immunity in protecting against herpesvirus infections. CONCLUSIONS Thorough risk assessment before anifrolumab initiation, considering the patient's viral infection history, vaccination status, and potential exposure risks, is essential. Administration of recombinant zoster vaccine before anifrolumab therapy may benefit susceptible individuals.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anticuerpos Monoclonales Humanizados / Herpes Zóster / Lupus Eritematoso Sistémico Límite: Adult / Female / Humans / Middle aged Idioma: En Revista: Am J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anticuerpos Monoclonales Humanizados / Herpes Zóster / Lupus Eritematoso Sistémico Límite: Adult / Female / Humans / Middle aged Idioma: En Revista: Am J Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos